Media Matters: Polarization and Propaganda; and Medicare and Ongoing Privatization of Healthcare in the US

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Media Matters: Polarization and Propaganda; and Medicare and Ongoing Privatization of Healthcare in the US
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Mickey hosts the first segment of the show. His guest Kenn Burrows describes an upcoming conference “From Polarization to Integration,” to be held April 21 on the San Francisco State University campus. The event will address strategies for overcoming issues of censorship around important but controversial matters. Also joining Mickey and Kenn is journalist Tony Brasunas, author of the new book Red, White, and Blind, who presents examples of vital stories and opinions suppressed by corporate media and what we can do to expand our media diets. Then Eleanor Goldfield hosts the second half of the show; her guest, physician and political activist Dr. Margaret Flowers, details ways in which for-profit healthcare firms are taking over more and more segments of the US healthcare system, and reducing the quality of patient care.

Notes:
Kenn Burrows teaches Holistic Health at San Francisco State University and is a long-time contributor to Project Censored. Tony Brasunas is an independent journalist and the author of a new book, Red, White, and Blind: The Truth About Disinformation and the Path to Media Consciousness on the failures of corporate media, their ongoing propaganda campaigns, and what we the people can do to be more mindful about media matters. Dr. Margaret Flowers is a pediatrician, an advocate of single-payer healthcare financing, and a contributor to Popular Resistance.

 

Below is a rough transcript of Eleanor’s interview with Dr. Margaret Flowers

Eleanor Goldfield: Thanks everyone for joining us at the Project Censored Radio Show. We’re very glad right now to be joined by Dr. Margaret Flowers, who is the director of Popular Resistance and Host of Clearing the Fog. She is an advisor to the Board of Physicians for a National Health program and volunteered as a congressional fellow during Obama’s health reform process.

Dr. Flowers, thanks so much for joining us.

Dr. Margaret Flowers: Thank you for having me, Eleanor.

Eleanor Goldfield: So I’d like to start off with what, , occurred on March 31st. The date that Biden and his Democratic Congress marked as the end of continuous coverage, thereby kicking some 15 million people off of Medicaid. And now states are set to begin dropping people from the roles, meaning that the 90.9 million people are more than one in four Americans.

Who were enrolled in Medicaid as of August, 2022, will be facing life altering, or in some cases life ending upheavals in their ability to access care. So first off, I wanted to ask, how is it that Medicaid could just magically and elastically grow to offer coverage to millions of people and then it has to suddenly snap

Dr. Margaret Flowers: back?

Yeah, it’s so interesting. I mean it the. Covid 19 pandemic showed us a little sliver of what the US government could do. I mean, it could give people checks, it could make them not have to pay their rent or pay their, you know, student loan, you know, payments. It could stop evictions and it could offer healthcare to so many people because not only did it expand Medicaid, but it also covered.

You know, covid 19 tests and vaccines. And if you had to be hospitalized or if you needed medication, nobody could be turned away if they had covid 19 during the public health emergency. And that happened under Trump. It was the Trump administration that expanded funding to Medicaid, you know, for Medicaid to the states on the conditions.

Listen to this, because, you know, the Democrats, they, they’re just always so disappointing that nobody could be dropped. And they couldn’t restrict any of the benefits that was under the Trump administration. But then, you know, Biden back in September told everybody, Hey, pandemic’s over, go back to, you know, go back to your normal life.

And so that gave members of Congress and the Biden administration the cover to say, well, we don’t need this public health emergency anymore.

Eleanor Goldfield: Yeah. As, as you say, it’s, it’s so disappointing and, and remarkable to think that it was under Trump, that all these people had access to this care. And I, I wanna, I wanna make that distinction because I think some people, I mean, I myself have been on Medicaid.

Some people listening might have also or be on Medicaid. And. The, the call is for a nationally improved Medicare for all as opposed to Medicaid. Can you make that distinction as opposed, like, why is it not nationally improved? Medicaid for

Dr. Margaret Flowers: All right, so this is important because when Medicare and Medicaid were created in 1965 it, you had the southern dixiecrats, the, the Democrats who were, you know, racist and didn’t believe that everybody should have healthcare.

And so, As there was this big push to create what people had hoped would become a Medicare, that could be expanded to everyone. The it, the, I think it was Wilber Mills was the chair of the Health and Educational Welfare Committee put in what he considered to be a poison pill, and that was separating Medicare from Medicaid.

So Medicare being a national program for the elderly, but for the poor. Doing it on a state by state BA basis, and this is known as the Southern strategy. It was used for other things as well, because when you make it a federal program, everybody in the country gets the same. When you make it a state by state program, it’s up to the states to decide what’s covered, who’s covered, how they enroll, how often they have to enroll, and so they can make it a discriminatory system.

And in fact, you know, when I was out in Colorado, It was more than 10 years ago working with some of the healthcare folks out there on health reform. It was a state senator who was a doctor who told me that when they make their Medicaid regulations, they know a certain number of people who are eligible won’t sign up for whatever reason.

They can’t get it together to do that, or they don’t have access to what they need to do that, and they can’t. They figure that in that, you know, we’re gonna save this much money because we made people have to do this and that’s gonna be a barrier for them to get care. Well, under the family’s first act, under Trump enrollment was continuous.

Nobody had to worry about it. I mean, I. As you know, I adopted two children there during that time from a different state. They were on Medicaid there. Medicaid rolled right over to here, no problem. So you know, that’s the way it should be. But these barriers are intentional. Yeah.

Eleanor Goldfield: I mean, that, that alone is just, offers a, a great example as to why so often people stay in, in, in the places that they are, even if they’d like to move, oh, well I have to stay in this terrible job.

I have to stay in a state that I don’t like because I’m, I’m shackled to my ability to access the. Oftentimes measly care that I do get here, but I get some.

Dr. Margaret Flowers: Absolutely. I know people who have done that and people who have gotten divorced, even though they didn’t want to because they needed, they were sick and they needed to qualify for Medicaid.

It’s, it’s, you know, as you’d well know, it’s, it’s a very perverse and sick system, but this is why we need a national system because we don’t wanna leave it up to different states. We want everybody in the United States and the territories to have the same healthcare and the, the ability. To go where you wanna go.

If you under a national Medicare for All system, if you’re traveling wherever you are, you’re still covered. If you need to move, you’re still covered. Whatever your life status is and age, you’re covered. And that’s what other countries do. And you know, we’re the only wealthy nation that doesn’t, so you know, this is what we’re calling for.

Eleanor Goldfield: Yeah. Pretty, pretty basic, not really radical. Right? Right. Well, and, and, and also in in Medicare news, I, I recently saw that common Dreams had reported on this, that the United Health Group which is a dominant entity in the very lucrative Medicare advantage. Market saw a stock jump over the past week as Wall Street analysts and investors have embraced the Biden administration’s decision to delay reforms aimed at tackling abuse in the privately run, but government funded health program.

And C M s Centers for Medicare and Medicaid Services said that Medicare advantage payments would rise by nearly 14 billion. Next year under this new plan with United Health Group alone, seeing a potential $900 million, $900 million in additional profit. So now that seems like there’s, you know, on the surface, a lot of money going into Medicare, but clearly not going actually to deliver care.

But going into the pockets of these investors, what. What is actually going on? What is Medicare advantage and what is, what is that racket?

Dr. Margaret Flowers: This is something for people to need to understand because Medicare Advantage was started a few decades ago under the, You know, the rationale that Congress gave was that people want choice.

You know, they don’t just want traditional Medicare. They wanna be able to choose other plans as well. Of course, we can guess who made that talking point up and who wrote that legislation. And so there’s been a steady privatization of Medicare, as in health insurance corporations like Cigna and others are allowed to offer plans.

What’s interesting is that the, the research shows that one, they cherry pick their seniors. They have ways of doing it so that they go to senior centers, cuz that’s where your healthier seniors are gonna be. They put their offices on the second or third floor with no elevator. So only people who can, you know, have the ability to walk up the stairs can get there and they.

Restrict services. So when people get sick and they start to realize, oh, hey, this isn’t covering what I need to cover. My rehab is not gonna be adequate, or I have to pay so much out of pocket. They drop out of the Medicare Advantage plans and go to the traditional plan. So they cherry pick off the healthiest ones.

And then on top of that, they get more money for each enrollee than original Medicare does. So they’re taking care of the sickest population and getting more money for it. And the fraud, you know, they, they up code. So they’ll make somebody, you know, maybe somebody has mild heart disease, they’ll make it moderate heart disease, you know, just so they can charge a little bit more for that to the government.

So since the passage of the Affordable Care Act in 2010, which created this new center for Medicare and Medicaid innovation, which has been driving this, and actually the woman who was the architect of the aca, Liz Fowler, who’s a insurance corporate. Senior Vice President, former Lee she’s oversaw the writing of the ACA and that passage through Congress.

Then Obama appointed her to Health and Human Services to write the regulations for it. And then she was put in charge of this Center for Innovation. And this has been driving this whole increasing privatization of Medicare as well as Medicaid increasingly privatized so that the vast majority of people on Medicaid are in these private, what they’re called MCOs managed care organizations.

Where they take 40 to 50% of the money they get from the government and put it into their c e o pay and, you know, administrative costs and not actually care. Traditional Medicaid has like a two or 3% overhead, so, you know, significantly different. And then they have been, you know, pushing these Medicare Advantage plans.

And now under this new program, a c o Reach under the Biden administration started under Trump. People called on Biden to end it, but instead they renamed it and kept the same program. People who are now in traditional Medicare under the a C O reach, private equity firms are buying up this these Medicare systems and enrolling.

Physicians in it. So you may be in traditional Medicare, but if your physician is now in this a C O reach, you’re effectively in a private Medicare program that you didn’t choose or have any say over. And most people are not even aware of it. So Wendell Potter had an interesting study recently that found, it used to be, you know, a few years ago, I was saying that the major health insurance corporations get more than 50% of their revenue from the government, either through Medicaid, Medicare, or the subsidies to buy insurance.

Now for the top three, it’s 90% of their revenue. So I mean, the, the government is a cash cow. They, you know, they would rather the government just cut them these big checks than have to worry about whether people can pay them or not. So, so we’re seeing this increasing privatization of our systems and with that discrimination dropping patients.

We had a doc here who saw mainly Medicaid patients at a hospital, and the hospital canceled his Medicaid insurance because he was giving too much care to his pa, too much to his patients. You know, in, in other words, he was actually giving them care, you know? So, yeah, it’s this is the direction that we’re going and it’s, it’s a sad thing because people who advocate for a universal system have been now placed in the position of just trying to defend the public systems that we have.

Eleanor Goldfield: Yeah. It’s like ugh. Well, and it, and, and what you’re describing is also so convoluted. It’s like, well, this person, your doctor’s in this system, you might think you’re in this system. It’s like, wow. It just sounds like such a. A a, a cluster, like a, a, a tight knitted spider web of a mess. And it’s like, wow, just one system would just make this, but of course then all of these companies would lose out on their cash cow of 90% of their incomes.

So of

Dr. Margaret Flowers: course that’s, yeah, it’s, I mean the, the, the health insurance corporations are making, they’re doing better than most of the other sectors, you know, industrial sectors. In the United States so that that says something in the, and the insertion of private equity into our healthcare system has been really disastrous for our system and for people overall.

Eleanor Goldfield: Yeah, and I actually wanted to touch on that because you mentioned, you mentioned Wendell Potter’s study and, and and there’s you know, public citizen also worked on, on putting this out, putting that report out and talking about The private equity toll on US healthcare and like on dozens of areas.

For instance nearly half of all home healthcare deals in 2018 and 2019 involved private equity, and that actually increased in 2020. Another example, private equity companies have bought up three of the four major staffing companies for obstetrics emergency departments and emulating some of the profitable tactics that they used.

But in a gray area around the standards for defining live births as emergencies, which if you talk to a midwife, they make very clear being pregnant and giving birth is not an emergency unless it’s an emergency. Right. And in fact, a normal thing, they’ve been accused of classifying normal births as emergencies.

So they can charge patients additional fees you know, forcing c-sections on people when they’re not necessary. And as one doctor put it with regards to this private equity boom, you can’t serve patients and investors at the same time. And so I, I’m curious what your reaction is to this and, and whether you feel like, you know, this is, this is something that seems to be growing, and if so, what was the, what does the future hold if this continues

Dr. Margaret Flowers: unabated?

Right, right. Well, and, and that’s the, the conundrum, right? You can’t have a healthcare system that’s based on profit and try to make it about health. And that’s what’s been so difficult for health professionals in this country is that for most people, you go into your job wanting to take care of patients, and then you find that you’re just a little cog in this big machine that really doesn’t care about you or your patients.

It just is what, what kind of numbers, you know, can you generate So, Again, I would tie this back to Obama’s Affordable Care Act, which put in place a system that has driven consolidation of our healthcare system in a way that we had not seen prior to that. So that what we’re seeing is something called vertical integration.

So corporations come in. They have their own Medicaid and Medicare plans. They own the hospitals, they own the physician practices, the laboratories, the home health, the senior, you know, living whatever long-term care centers, they own it all. It gives them tremendous control over that. And that was the situation that this one doctor locally that I knew.

Got into that. He worked for a hospital that had its own Medicaid. And so when he was using too much care, they just dropped him and he lost his ability to take care of all those patients. But we’ve also seen in that same medical system that they shut down entire departments, pediatrics, obstetrics, psychiatry, with just a few days notice, literally like two days notice to all the staff.

Your jobs are gone, your department is closed, but they’re building these huge outpatient centers for cardiology and for orthopedics cuz those are the big money makers or. You see firms investing, you know, buying up hospitals and these things this loads them with debt from the outset. Then they mismanaged them and basically rob everything they can, and then they bolt and leave that facility.

We, you know, we’re losing so many of our hospitals, rural hospitals closing down because these vulture capitalists come in and take them over. Long term, you know, facilities, hospitals in cities, you know, St. Vincent’s in New York, Hahneman in Philadelphia, others out in LA with that have served low income residents for, you know, a hundred years.

And then they get bought up by these private entities and sold off for luxury condos. So. This is what we’re seeing is that these corporations just see our healthcare system as a way to make profit. And as that continues to grow, it’s gonna continue to mean that, that people will lose access to care or have face price gouging.

We know that pro privately run entities have lower quality, lower standards than the ones so it impacts, you know, the quality of care as well. This is this is not a, it’s a very disturbing direction. It also, The, the whole idea of having like the small practices is gone because on after the aca, the insurance companies just started dropping a lot of the practices docs for no reason.

It was random. Lost their ability to care for these patients that had this insurance and that drove them into a corporate system so they could be in that insurance. They need to be part of a big enough system to be covered, you know, to be included in that insurance so they could see their patients, and then that just turns them, again, they’re, they’re just a corporate, you know, entity.

It’s a matter of survival for them, but it’s a miserable situation.

Eleanor Goldfield: Yeah. And again, this highlights why, you know, so many people point to the ACA and they’re like, well, you know, it did so much good and it’s what we could do at the time, and no, it’s really not what we could do at the time. And that, and that, that kind of leads me to the next question is that, you know, you, you pointed out that people end up kind of back on their heels defending, you know, the scraps that we have as opposed to demanding.

Basic, the basic human right of healthcare. And so do you feel like right now it this pushing for something stop gap, like let’s, well, let’s get these 15 million people back on the roles. Like is it worth pushing for that or is it just like, you know what, no, we’re done pushing for scraps. Let’s it’s, it’s either this Medicare for all universal system or nothing.

You

Dr. Margaret Flowers: know, I think that We should be pushing for a whole package of things, not, not just healthcare, but given the end of this public health emergency, there should be more clamor about not, not ending it, not kicking people off of their insurance, actually covering long-term the things that people need, like tests and masks and medications, and, and care if they need it.

Pushing for, you know, better unemployment benefits, the things that we had, you know under the Trump administration. We should be saying that we should have that. But I think what. People have given up on, and, and we, we must, we shouldn’t give up on this. It’s continuing to push for a national health insurance or a national health system, a universal healthcare system that’s publicly financed that covers everything.

And that’s because it’s a public system doesn’t have the profit motive. We need to take that out. And in fact, There is a piece of legislation that’s gonna be introduced in the near future by Representative Perilla Japa, a Democrat from Washington State. She’s introduced to Medicare for All Act previously, and you know, it’s, there’s a lot of good things about it, but it has some pretty glaring weaknesses.

And so there’s actually a call right now to push her. To fix the legislation because we know that you have to start out with the strongest piece of leg legislation that you can, cuz it’s gonna get whittled down and attacked as it goes through that whole process. So her legislation does not get rid of the for-profit sector so they can continue to rake in the money off of the government despite the fact that there’s a clear plan for how to do that, how to buy out those services and, and continue to have those facilities.

It doesn’t include a just transition for people who are lose their job because of the new system. That’s something the old legislation had. You know, it had a couple of years of salary guaranteed plus retraining prioritization to get into the new system, to be hired into it. It doesn’t include it, it, it includes this Year, like half the population would go in one year and then another half would go in the other year.

That doesn’t make any sense. The legislation that we were advocating for was like, on this day, everybody in the country is in, that’s the simplest way to do it. It’s the most cost effective way to do it. And then it doesn’t include a mechanism for funding. So the United States has one of the most regressive.

Healthcare funding schemes in the world where if you’re poor, you pay more for out of, you know, for your care than if you’re wealthy as a proportion of your income. We need to make sure that we turn that around and that it is the wealthier people who are paying more into the system. So, yeah, I mean the long and short answer is we should be demanding everything, but we should definitely be focused on pushing for a national system and not get distracted away from that.

Cuz the only way we’re gonna win a national system is when we’re loud enough and strong enough to demand that we have it

Eleanor Goldfield: right. And I, I. I’m, I’m just caught wondering if, if her bill does not get rid of the for-profits, I mean, then you can’t actually have Universal healthcare. If it is still a system with a for-profit aspect, then it can’t actually be care-based if it’s profit based.

Right,

Dr. Margaret Flowers: right. And, you know, and the Sanders legislation the same thing. It, it was mind-boggling because we were meeting, you know, with both of them and saying, this doesn’t make sense if you cause their, their whole point was, well, we’re gonna regulate the for profits. Like we’ve seen, you know, we, we also regulate our private health insurance.

That hasn’t worked very well. They either hide what they’re doing or sometimes we actually are successful in auditing them and we find out that they literally they just, people submit a claim, the insurance company is supposed to cover it, and they just toss it in, like one in five. In Maryland, they just toss them in the trash or.

This whole system that was exposed recently where the docs are basically, the medical directors of these health insurance corporations are not even actually reviewing the claims that come in. It’s a computer generated system. The docs sign off on batches of it, and they’re able to deny. Care that should be covered to tens of thousands of people every day.

You know this is the way that the system, you know, the, it’s not actually a system. If you think that your health insurance company is actually looking at your case and you know, whether that care is medically necessary, it’s not. Most people have to really fight to get their, their care covered.

Eleanor Goldfield: Yeah, of course.

And that’s a calculation too, because most people don’t have the time or the energy or the AC the ability to fight it. So they figure, well, a, a lot of people who would fight it won’t. And so we’ll get rid of them. And then there’s like, you know, a small percentage of people that will fight hard enough that we finally say, okay, fine.

And then it doesn’t really dent their bottom line at all anyway, because it’s such a small percentage of people who can do that.

Dr. Margaret Flowers: Exactly. Exactly. As we well know from a good friend of ours who was denied Karen, and we. Everybody had to fight very hard to expose that. Yeah. Yeah. It’s you if you don’t have that social network or you’re, you can’t market yourself well enough on GoFundMe.

You know, people are really in trouble here in the United States, and it’s so, it’s such a capitalist system, right. You have to, you have to market yourself to be able to get donations so that you can live. It’s it’s cruel and, and it’s unusual compared to most other countries.

Eleanor Goldfield: Yeah. I, and it’s like a very bad Black Mirror episode.

Yeah, I can imagine that I, and, and this is, this is kind of off topic, but, but connected because it does show, like you said, that we, we should be pushing for these, like a package of things, not just one, one sliver. And I know that you’ve talked about on your, on your radio show, clearing the fog and unpopular resistance, the connectivity of all these issues.

And I’m also curious, like in terms of what Medicare for all a universal healthcare system would be able to do. You know, recently there was that move by that one judge, just one, you know, expletive that that was hoping to shut down access to the abortion pill Mifepristone, which is the most common form of abortion nationwide.

Is there anything that a universal healthcare system could do to keep one dude? From potentially, potentially ruining access to reproductive care like that.

Dr. Margaret Flowers: Well under a universal system, like I said, everybody is in that same system. The, the government defines what those benefits are, and then, and then you, it’s, it’s in law.

This is what you can have. And so I think it would make it much harder, not a lawyer but for one judge, judge to go after that entire system also. And this is the importance of solidarity. Of the concept of solidarity as opposed to charity and, and. You know, when people live in a country where they have a health system, a universal health system, from the poorest to the richest, you’re in the same system.

It raises the standard of that system because it’s really easy, you know? Frankly, a lot of people in the United States are not up in arms that poor people are getting poor care or no care. But if you’re in that, if you’re all in that same system, you’re gonna be defending that together and saying, you know, no, no, no.

You can’t take that away from us, or you can’t do that. So we need that social solidarity. Because every system, as we see in Canada, the United Kingdom, every system is under attacked by the profiteers. They’re trying to get into it as, as they can. And, and, you know, doctors and nurses are striking in the uk to fight to protect the integrity of their system.

So I think in that way it would make those kinds of scenarios less likely. And And it just, you know, the, the research shows you if you cover everything, you know the whole body. It’s all connected. We can’t, it’s such a ridiculous thing in the US that we say like, well, we’ll, you know, we’ll cover your lungs and your heart, but not your eyes and your ears or your brain or, or your reproductive organs, you know, body part medicine.

It doesn’t make any sense. If we enter a, a national, improved Medicare for all or national health system. Everything is covered what’s considered medically necessary, and it’s the health professionals that define what is medically necessary, not someone whose incentive, frankly is to deny you here. So it, it changes that whole, whole dynamic.

And we see that in the Veteran’s Administration, which unfortunately is also under attack and being privatized. But the doctors I know who work at the va, they’re salaried physicians. All they do is care for their patients. They, you know, they don’t have to worry about what’s gonna be paid for and what’s not.

They, their focus is on the health of their patients. And that’s what health professionals wanna do. It’s what we wanna do. We wanna take care of our patients. Use that knowledge we

Eleanor Goldfield: got. It’s in the Hippocratic Oath. Right? Exactly. Not to make a bunch of money that’s not part of the oath that you take.

Dr. Margaret Flowers: Right. And it was a very small minority of folks in my medical school class who seemed to really be interested in the money. Really it was. Most people were there, you know, earnestly wanted to study medicine and, and take care of people and do some good

Eleanor Goldfield: work. Yeah, and it just, again, like the capitalist system, like it takes that drive to support people and to give people care and it tries to, to, to basically bash it out of people by saddling them with this horrific system.

Yeah yeah,

Dr. Margaret Flowers: doctors spends so much time on paperwork. You know, it takes away from direct patient care. You have to fight with the insurance companies, not just to get the care for your patient, but once they agree, then just to get paid for it is a whole nother battle. Physicians and nurses across the country are, are, you know, they’re burning out very quickly and the health system, you know, tries to put it on them like, oh, you need to do more yoga, your work life balance.

They’re not recognizing that it’s the way the system is designed that’s driving that. You need to change the system if you wanna solve that problem, not offer yoga classes during lunch, you

Eleanor Goldfield: know? Yeah, it’s like you know, suggesting that somebody ha drink drink some tea and, and, and do a face mask.

Like, I’m sorry, that doesn’t fix capitalism.

Dr. Margaret Flowers: Exactly.

Eleanor Goldfield: Does it? That’s nice. But I, my problem is capitalism. Exactly. So, so Dr. Flowers I’m, I’m curious, how, how do you feel that people can best get involved with with this

Dr. Margaret Flowers: issue? Well, there is you know, there’s a number of organizations out there and state.

Chapters in groups, you know, healthcare for all type of groups or physicians for a national health program or this single national single payer coalition that is organized by some folks that I know and who are doing really good work. You need to plug in, you know, locally if you have You know, the first steps are always education.

People need to learn about this. And Physicians for National Health Program offers, it has a speaker’s bureau. So if you have an organization, you can reach out to P N H P and find a local member who will come and, and talk to your group in, in, in spreading the word to others in your community. So that whole organizing health affects everything.

So everybody. Needs to be coming together around this issue and, and fighting for it. So organizing and then putting pressure on your local legislators. As well as, you know, folks are finding alternative ways of kind of dropping out of the corporate system and finding ways to provide care through mutual aid efforts and.

I know a, a family doc out in Albuquerque who left corporate medicine and opened a, a practice that’s patient controlled and very affordable, and it’s expanding. It’s working. They don’t even do billing. They, you know, give their patient a bill when they leave the office, but they don’t go beyond that. But yet more than 90% of their patients are paying their bills, even if it’s coming by each week and dropping off five or 10 bucks, you know, until it’s paid off.

Because this, the clinic is actually serving them and they care about it. They want it to continue to exist. So, so people are, are doing that as well. And I think, you know, All of these types of things need to be done. There’s a lot of us, so folks can plug in based on where they see their strengths and the needs in their community to do that.

But I think one thing that’s become. Personally that I believe has become a distraction is the effort on state legislation because we can’t do this at the state level without making significant changes to federal law. And if we’re gonna fight to make changes to federal law, let’s just ask for a national health program and fight for that so that everybody has it.

And not like a few big states like California and New York. Create what they think are gonna be, you know, systems and then all that progressive activism is then channeled into trying to make that system work or get the federal changes. And and we lose a big chunk of folks, you know, from the fight for our national system.

Eleanor Goldfield: Yeah, I mean, basically, unless it seems like, unless you succeed, like, unless California became its own country, which I mean it could, it’s the sixth largest economy in the world. Then. You’re still stuck. Like you’re stuck. Mm-hmm. In a, that state system, if you go across the border, all of a sudden you are in, you know, the no man’s land of healthcare just seems like a very, again, like you pointed out, like fighting for something that is less than what you want, just because you think you might be able to get

Dr. Margaret Flowers: that.

That’s been the problem for the last more than 100 years. There’s a, a medical historian, David Barton Smith, who’s written some very good work on this. And, and there’s actually a movie that came out of his book called The Power to Heal that chronicles the whole struggle for Medicare and Medicaid in the 1960s.

But he breaks up our last a hundred years into, you know, five phases and in each phase, People compromised instead of asking for what they wanted and in, and as a, as a result, our system has just been getting worse and worse and worse over that whole time. So we need to stop compromising. Healthcare is fundamental.

We know how to fix it. It’s very simple. Everybody in the same system, public financing, so it’s transparent. That saves tremendous, hundreds of billions of dollars a year would be saved if we went into a single system just because you cut out all that profiteering, all those administrators, we have an incredibly.

Bulky system of administrators who are just there to make it well, to make money personally and to make the system more complicated for other people. They, their, their obstacles to care in our country. So so we need to stop compromising and, and really finally demand what it is that we need.

Eleanor Goldfield: Very well put and I think a good way to, good way to wrap it up.

I definitely recommend that folks check out popular resistance.org. It is such a, an amazing hub of information and indeed tools for organizing and the like Dr. Flowers. Is there anywhere else that you’d like to tell folks to look for your work or things related to this issue?

Dr. Margaret Flowers: Well, as you said, follow my podcast clearing the fog, which you can find at Apple and Spotify.

Not Spotify, sorry, not that. Google Play and some others. But it’s on popular resistance as well. Currently right now we’re not running the, the campaigns but I, that we were running in the past. But the National Single Payer Group folks should look for that national single payer and and plug in with them if you wanna, if you wanna really work on healthcare and then physicians for a national health program.

I’m sorry, we were talking about my work. But anyway you don’t have to be a physician to join that. But you know, those are the main things right now. Popular resistance is the best way to find me. And I also work with the United National Anti-War Coalition and the US Peace Council and the Sanctions Kill Campaign.

So folks wanna check those out too. Awesome.

Eleanor Goldfield: Yeah. You’re, you’re never bored, I think. Thanks. Thanks so much Dr. Flowers. Appreciate it.

Dr. Margaret Flowers: Thank you.